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https://www.readbyqxmd.com/read/29337126/rigid-plate-fixation-vs-wire-cerclage-patient-reported-and-economic-outcomes-from-a-randomized-trial
#1
Keith B Allen, Vinod H Thourani, Yoshifumi Naka, Kendra J Grubb, John Grehan, Nirav Patel, T Sloane Guy, Kevin Landolfo, Marc Gerdisch, Mark Bonnell, David J Cohen
BACKGROUND: In a multicenter randomized trial, sternal closure following cardiac surgery using rigid plate fixation (RPF) compared with wire cerclage (WC) resulted in improved sternal healing, reduced sternal complications and was cost neutral at 6 months. Additional secondary endpoints are presented from this trial. METHODS: Twelve US centers randomized 236 patients to RPF (n=116) or WC (n=120). Patient reported outcomes measures (PROMs) including pain, function, and quality-of-life (QOL) scores were assessed through 6-months and correlated to computed tomographic derived sternal healing scores using logistic regression...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29337124/evaluation-of-prophylactic-antibiotic-use-for-delayed-sternal-closure-post-cardiothoracic-surgery
#2
Jamie L Eckardt, Matthew R Wanek, Chiedozie I Udeh, Elizabeth A Neuner, Thomas G Fraser, Tamer Attia, Eric E Roselli
BACKGROUND: Clinical practice guidelines provide recommendations for surgical prophylaxis in patients undergoing cardiothoracic procedures. However, there are currently no recommendations guiding the management of antibiotic prophylaxis in patients requiring delayed sternal closure following cardiothoracic surgery. METHODS: This is a single-center, retrospective analysis. Data was extracted from the Society of Thoracic Surgery (STS) Database and electronic medical record for the time period of July 2011 - January 2016...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29332913/early-extubation-in-the-operating-room-after-congenital-open-heart-surgery
#3
Takuma Fukunishi, Norihiko Oka, Takeshi Yoshii, Kensuke Kobayashi, Nobuyuki Inoue, Tetsuya Horai, Tadashi Kitamura, Hirotsugu Okamoto, Kagami Miyaji
Early extubation in the operating room after congenital open-heart surgery is feasible, but extubation in the intensive care unit after the operation remains common practice at many institutions. The purpose of this study was to evaluate retrospectively the adequacy of our early-extubation strategy and exclusion criteria through analysis based on the Risk Adjustment in Congenital Heart Surgery method (RACHS-1).This retrospective analysis included 359 cases requiring cardiopulmonary bypass (male, 195; female, 164; weight > 3...
January 15, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29325026/failure-of-sternal-wires-depends-on-the-number-of-turns-and-plastic-deformation-combined-experimental-and-computational-approach
#4
Lukas Capek, Petr Henys, Martin Kalab, Pavel Solfronk
OBJECTIVES: The number of turns at the end of a wire closure is not described or discussed in any cardiosurgical guidelines. The hands-on experience of the surgeon plays a significant role. The aim of this work was to clarify the relationship between the number of turns of the suture and the resulting strength of the sternal fixation. METHODS: The study was performed in 2 independent steps. The first step was a finite element simulation, where the stress and strain distribution of the sternal fixation was observed...
January 8, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29319633/risk-factors-for-healthcare-associated-infections-after-pediatric-cardiac-surgery
#5
Takeshi Hatachi, Kazuya Tachibana, Yu Inata, Yuji Tominaga, Aiko Hirano, Miyako Kyogoku, Kazue Moon, Yoshiyuki Shimizu, Kanako Isaka, Muneyuki Takeuchi
OBJECTIVES: Healthcare-associated infections after pediatric cardiac surgery are significant causes of morbidity and mortality. We aimed to identify the risk factors for the occurrence of healthcare-associated infections after pediatric cardiac surgery. DESIGN: Retrospective, single-center observational study. SETTING: PICU at a tertiary children's hospital. PATIENTS: Consecutive pediatric patients less than or equal to 18 years old admitted to the PICU after cardiac surgery, between January 2013 and December 2015...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29318024/congenital-cranial-ventral-abdominal-hernia-peritoneopericardial-diaphragmatic-hernia-and-sternal-cleft-in-a-4-year-old-multiparous-pregnant-queen
#6
Camille Bismuth, Claire Deroy
Case summary: Cranial ventral midline hernias, most often congenital, can be associated with other congenital abnormalities, such as sternal, diaphragmatic or cardiac malformations. A 4-year-old multiparous queen with a substernal hernia was admitted for evaluation of a mammary mass. During CT examination, a bifid sternum, the abdominal hernia containing the intestines, spleen, omentum, three fetuses, a mammary mass and an incidental peritoneopericardial diaphragmatic hernia were identified...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/29310938/evaluation-of-the-clinical-utility-of-transesophageal-echocardiography-and-invasive-monitoring-to-assess-right-ventricular-function-during-and-after-pulmonary-endarterectomy
#7
Thomas P Sullivan, James E Moore, Andrew A Klein, David P Jenkins, Lynne K Williams, Andrew Roscoe, Wendy Tsang
OBJECTIVE: Patients undergoing pulmonary endarterectomy (PEA) have impaired right ventricular function. The authors sought to assess the clinical utility of commonly used perioperative echocardiographic and right heart catheter measurements in patients undergoing PEA. DESIGN: A single-center prospective observational study. SETTING: The study was conducted in a quaternary care cardiac surgical center in the United Kingdom. PARTICIPANTS: Patients undergoing PEA between April 2015 and January 2016...
September 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29310554/primary-arterial-switch-operation-for-late-referral-of-transposition-of-the-great-arteries-with-intact-ventricular-septum-in-the-current-era-do-we-still-need-a-rapid-two-stage-operation
#8
Noritaka Ota, Sivakumar Sivalingam, Kiew Kong Pau, Chee Chin Hew, Jeswant Dillon, Haifa Abdul Latiff, Hasri Samion, Mohd Azhari Yakub
OBJECTIVE: We introduced primary arterial switch operation for the patient with transposition of great arteries and intact ventricular septum (TGA-IVS) who had more than 3.5 mm of posterior left ventricle (LV) wall thickness. METHODS: Between January 2013 and June 2015, a total of 116 patients underwent arterial switch operation. Of the 116 patients, 26 with TGA-IVS underwent primary arterial switch operation at more than 30 days of age. RESULTS: The age and body weight (mean ± SD) at the operation were 120...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29303867/a-new-device-for-securing-sternal-wires-after-median-sternotomy-biomechanical-study-and-retrospective-clinical-assessment
#9
Matthew R Danter, Amy Saari, Min Gao, Anson Cheung, Samuel V Lichtenstein, James G Abel
OBJECTIVE: Morbidity due to sternotomy continues to be a significant clinical problem. Poor approximation of the sternum may lead to complications such as sternal dehiscence, infection, and pain. A device to assist in tensioning and twisting standard steel wires during sternal closure has been developed (TORQ sternal closure device). Manually tightened interrupted wire closures were compared with those tightened and secured with the aid of the device. Performance of the device was assessed clinically...
January 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29258527/case-report-osteogenesis-imperfecta-internal-mammary-artery-graft-nitinol-clips
#10
Ludovic Melly, Anne-Sophie Dincq, Claude Hanet, Benoît Rondelet
BACKGROUND: Osteogenesis imperfecta is a genetic disorder of connective tissue causing mostly left-sided heart valves and aortic root pathologies, but a coronary artery involvement reflecting an increased sensitivity to cardiovascular risk factors is also suspected in this patient population. CASE PRESENTATION: We report a 38-year-old patient with an osteogenesis imperfecta and a typical presentation of an acute myocardial infarction. The coronary angiogram showed a coronary 3-vessel disease...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29243798/effects-of-propofol-or-sevoflurane-anesthesia-on-the-perioperative-inflammatory-response-pulmonary-function-and-cognitive-function-in-patients-receiving-lung-cancer-resection
#11
H-T Tian, X-H Duan, Y-F Yang, Y Wang, Q-L Bai, X Zhang
OBJECTIVE: To investigate the effects of propofol and sevoflurane anesthesia on the inflammatory response, pulmonary function and cognitive function of patients undergoing lung cancer resection and their differences. PATIENTS AND METHODS: 62 patients with lung cancer who underwent pulmonary lobectomy from January 2014 to January 2016 in Jining First People's Hospital were selected and randomly divided into two groups: the propofol group (n=31) and the sevoflurane group (n=31)...
December 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29211217/application-of-unilateral-pectoralis-major-muscle-flap-in-the-treatment-of-sternal-wound-dehiscence
#12
Grazielle de Souza Horácio, Pedro Soler Coltro, Antonio Albacete, Juliano Baron Almeida, Vinícius Zolezi da Silva, Ivan de Rezende Almeida, Alfredo José Rodrigues, Jayme Adriano Farina
OBJECTIVE: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. METHODS: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29165758/therapeutic-strategy-for-multiple-vsd-combined-with-mvsd-in-infants-and-young-children
#13
Y-B Hu, J-Q Zou, L Wang, G-Y Liu
OBJECTIVE: To investigate the therapeutic strategy for the multiple ventricular septal defects (VSD) combined with a muscular ventricular septal defect (MVSD) in the infants and young children. PATIENTS AND METHODS: We analyzed clinical data of 63 child patients with multiple VSD who received the treatment between January 2009 and April 2013 in our hospital. There were 33 males and 30 females, the patients aged from 6 to 28 (10 ± 6) months and weighed between 5...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29156020/doubly-committed-ventricular-septal-defect-closure-using-eccentric-occluder-via-ultraminimal-incision
#14
Jin Yu, Lianglong Ma, Jingjing Ye, Zewei Zhang, Jianhua Li, Jiangen Yu, Guoping Jiang
OBJECTIVES: This study aimed to investigate the safety, feasibility and availability of doubly committed ventricular septal defect (DCVSD) closure via an ultraminimal intercostal incision under the guidance of transoesophageal echocardiography in children. METHODS: From August 2014 to August 2016, 35 children with DCVSDs (≤5 mm in diameter) were enrolled in this study. A left parasternal ultraminimal intercostal incision (≤1 cm) and a pericardium hanging technique were employed without sternal incision...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#15
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte® ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg-1 . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29147786/risk-factors-for-development-of-ectopic-atrial-tachycardia-in-post-operative-congenital-heart-disease
#16
Bradley C Clark, John T Berger, Charles I Berul, Richard A Jonas, Jonathan R Kaltman, Julianne Lapsa, Dilip S Nath, Elizabeth D Sherwin, Pranava Sinha, David Zurakowski, Jeffrey P Moak
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29140967/near-infrared-spectroscopy-and-vascular-occlusion-test-for-predicting-clinical-outcome-in-pediatric-cardiac-patients-a-prospective-observational-study
#17
Ji-Hyun Lee, Young-Eun Jang, In-Kyung Song, Eun-Hee Kim, Hee-Soo Kim, Jin-Tae Kim
OBJECTIVES: This study is designed to determine the feasibility and utility of vascular occlusion test variables as measured by INVOS Medtronic, Dublin, Ireland) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A tertiary children's hospital. PATIENTS: Children less than or equal to 8 years old who were scheduled for elective cardiac surgery under cardiopulmonary bypass. INTERVENTIONS: A vascular occlusion test (3 min of ischemia and reperfusion) was performed on the calf at three time points: after induction of anesthesia (T0), during cardiopulmonary bypass (T1), and after sternal closure (T2)...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29104198/-feasibility-of-super-bioabsorbable-plate-insertion-into-the-sternum-manubrium-for-sternal-closure
#18
Yumi Kando, Mutsumu Fukata, Naoko Sakagami, Hitoshi Terada
We evaluated the efficacy of our sternum closure technique. Out of the 101 patients who underwent cardiovascular surgery at our department, 36 patients underwent sternum closure using ultra-high molecular weight polyethylene tape (NT) with Super FIXSORB MX40 (SF40) insertion into the sternum manubrium (group A) and 19 patients used NT with Sterna Lock Blu (group B). None of the patients had sternum disruption. Postoperative computed tomography scan revealed comparable effect in preventing transverse and anterior-posterior sternal displacement between the 2 groups...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29075945/use-of-freeze-dried-bone-allografts-in-osteoporotic-patients-undergoing-median-sternotomy
#19
Mei Liang, Jianzhou Liu, Qi Miao, Guotao Ma, Xingrong Liu, Xiaofeng Li, Chaoji Zhang
Osteoporosis is a major risk factor for deep sternal wound infection, which is a rare but serious complication after median sternotomy. We investigated the incidence of deep sternal wound infection and the protective effect of bone allografts in osteoporotic patients after sternal approximation. Data were collected retrospectively from consecutive osteoporotic patients who underwent cardiac surgery via median sternotomy. Sternal approximation in the historical control group was performed with conventional steel wire sutures...
October 26, 2017: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29066145/intravenous-acetaminophen-does-not-decrease-persistent-surgical-pain-after-cardiac-surgery
#20
Alparslan Turan, Nika Karimi, Nicole M Zimmerman, Stephanie L Mick, Daniel I Sessler, Negmeldeen Mamoun
OBJECTIVE: The authors investigated the hypothesis that perioperative acetaminophen reduces incisional pain at 30 and 90 days. DESIGN: This was a prospective, randomized, double-blind trial. SETTING: Tertiary-care hospital (single center) cardiac surgery unit. PARTICIPANTS: Patients undergoing cardiac surgery via median sternotomy. INTERVENTIONS: Patients were assigned randomly to intravenous (IV) acetaminophen or IV placebo...
May 17, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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